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Case report
Rare cause of right iliac fossa pain in a UK patient
  1. Khurram Shahzad1,
  2. Mohamed Elmedani2,
  3. Smitha Mathew2 and
  4. Ioannis Peristerakis3
  1. 1Radiology Department, Royal Bolton Hospital NHS Foundation Trust, Bolton, UK
  2. 2Radiology Department, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
  3. 3Colorectal Surgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
  1. Correspondence to Dr Mohamed Elmedani; mohamed.elmedani{at}hotmail.co.uk

Abstract

A 62-year-old Asian man presented with a 3-month history of right iliac fossa pain which had progressively worsened over the last 3 weeks. All blood parameters were found to be unremarkable except for mildly elevated erythrocyte sedimentation rate. CT imaging demonstrated thickening of the ascending colon and caecum. Colonoscopic biopsies showed submucosal granulomas with features suggestive of schistosomiasis and parasite serology was positive for Schistosoma antibodies. He was treated with praziquantel and showed subsequent symptomatic and radiological improvement. However, he represented nearly 2 years later and underwent a right hemicolectomy for small bowel obstruction. The resected bowel showed an inflammatory caecal mass and a terminal ileal adenocarcinoma.

  • infections
  • general surgery
  • radiology
  • tropical medicine (infectious disease)

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Footnotes

  • Contributors KS and ME shared writing the original case report including background, investigations, follow-up and treatment. This was reviewed by IP who was the surgeon in charge of the case. He advised on the clinical story, as well as follow-up, and reviewed and edited the document. SM supervised, reviewed and edited the case report, as well as provided images and pathology.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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